ASIAN PACIFIC COUNSELING AND TREATMENT CENTERS
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APCTC FORMS

These documents recently have been updated.  Translations to other languages will be available soon.  
CONSENT FORM - ENGLISH
CONSENT FORM - KOREAN
CONSENT FORM - SPANISH
CONSENT FORM - TRADITIONAL CHINESE
APCTC WELCOME PACKET - ENGLISH
CONSENT FORM - VIRTUAL ART GALLERY

PHI AUTHORIZATION - ENGLISH
PHI AUTHORIZATION - KHMER
PHI AUTHORIZATION - KOREAN
PHI AUTHORIZATION - SIMPLIFIED CHINESE
PHI AUTHORIZATION - SPANISH
PHI AUTHORIZATION - TRADITIONAL CHINESE
PHI AUTHORIZATION - VIETNAMESE

​LOS ANGELES COUNTY DEPARTMENT OF MENTAL HEALTH FORMS


notice of privacy practices - english
notice of privacy practices - spanish
Los Angeles County Behavioral Health Services - Member Handbook -multiple languages
patients' rights consumer resource directory - english
REQUEST FOR CHANGE OF PROVIDER FORM - ENGLISH
REQUEST FOR CHANGE OF PROVIDER FORM - SPANISH
beneficiary/client grievance or appeal and authorization forms - multiple languages
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LOS ANGELES COUNTY DEPARTMENT OF MENTAL HEALTH PROVIDER DIRECTORY

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LINK TO DIRECTORY

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Copyright © 2015
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  • HOME
  • ABOUT US
    • History and Mission
    • APCTC Staff
    • APCTC Leadership
    • APCTC Advisory Board
  • PROGRAMS & SERVICES
    • Enrolling in Services
    • Program Brochure
    • Resources
    • Media
    • Blog
    • FAQS
  • EVENTS
    • Los Angeles County Events
    • Riverside County Events
    • Art Showcases >
      • Past Art Showcases >
        • 2024 ART SHOWCASE - Collaboration in The Journey of Healing
        • 2023 ART SHOWCASE - This is MY VOICE
        • 2022 ART SHOWCASE - Make a Difference Together
        • 2021 ART SHOWCASE - Journey of Healing
    • Archive
  • JOIN US
    • Employment Opportunities
    • Training Opportunities
  • FORMS
  • CONTACT US
  • DONATE